See a Peripheral Artery Disease Specialist

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Peripheral Artery Disease Specialist Dr. Michael Lalezarian

At ProVascularMD, we provide comprehensive care for peripheral artery disease and its complications. Browse our educational resources to learn more about stages, symptoms, diagnosis, and treatment.

When you’re ready to see a peripheral artery disease specialist, we’re here to help. Dr. Michael Lalezarian is double-board certified Vascular and Interventional Radiologist at ProVascularMD that specializes in peripheral artery disease and minimally invasive treatments. Dr. L is a committed partner in the battle against vascular diseases. He values spending quality physician time with his patients to address their needs and concerns, and assist them on their journey to better health.

ProVascularMD Review Score for office in Victorville, California

“Dr. L changed my life. He’s knowledgeable, caring and my experience with his office staff was as good as it gets. I wish all of my doctor visits felt this way. After a few pregnancies I was having incredibly painful varicose veins that was really wearing on me. The treatment was practically painless and I’m so happy with my results. He’ll be my vascular doctor moving forward.”

Michelle H, February 2022

ProVascularMD credentials with UCLA David Geffen School of Medicine
ProVascularMD credentials with American Medical Association
ProVascularMD credentials with American Board of Radiology
ProVascularMD credentials with Society of Interventional Radiology
ProVascularMD credentials with Alpha Omega Alpha Honor Medical Society

Stages of Peripheral Artery Disease

Peripheral artery disease is a chronic, progressive disease. Symptoms can be intermittent and difficult to detect in the early stages, but absolutely excruciating in the late stages. Understand where you’re at in the progression. Learn more about the different stages of peripheral artery disease below.

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Peripheral Artery Disease

Peripheral artery disease is caused by the formation of atherosclerotic blockages in the arteries, usually in the legs. Individuals with peripheral artery disease often have difficulty walking for an extended duration due to cramping pain (claudication) caused by insufficient blood flow.

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Critical Limb Ischemia

Critical limb ischemia is what develops when peripheral artery disease is left untreated. Blood flow through the leg becomes so restricted that pain is experienced at rest. Ulceration and gangrene are also common. Amputation is imminent without intervention.

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Arterial Ulceration

Arterial ulcers can develop where blood supply is most limited, usually at the farthest parts of the body such as feet, toes, side of the ankle, or areas of pressure to the skin. Arterial ulcers are indicative of late-stage peripheral artery disease and require intervention to heal.

Peripheral Artery Disease Symptoms

Do you experience cramping pain in your legs after walking long distances? This is one of the most telling signs of peripheral artery disease, and it tends to get worse if left untreated. Get back on your feet. Get relief from the symptoms of peripheral artery disease. Visit us at ProVascularMD to learn how we can help.

Peripheral artery disease leg discomfort icon   Leg Discomfort

Generalized leg discomfort should be cause for alarm in diabetics, smokers, and the elderly. Leg pain is certainly not specific to peripheral artery disease, but it may be the first sign that vascular issues are present.

Peripheral artery disease claudication icon   Claudication

Claudication describes a cramping pain that is felt in the hips, thighs, buttocks, calves, or feet during exercise that then subsides when resting. This is the most telling symptom of peripheral artery disease and should be taken very seriously.

Peripheral artery disease cold feet icon  Cold Feet

Lack of blood flow and poor vascularity can render the lower extremity exceptionally cold. Cold feet can indicate peripheral artery disease, espcially when one foot is significantly colder than the other.

Peripheral artery disease weak pulse icon   Weak Pulse

A simple pulse check can be very telling. A weak or absent pulse at the groin, behind the knee, on the inner ankle, or on the top of the foot can indicate peripheral artery disease.

Peripheral artery disease rest pain icon   Rest Pain

Pain may persist even when sitting or lying down. This pain typically affects the forefoot and toes. By the time patients experience rest pain, it is likely that peripheral artery disease has progressed to an advanced stage.

Peripheral artery disease tissue loss icon  Tissue Loss

Tissue loss occurs when tissue in the leg or the foot does not have an adequate blood supply. This can present as skin color changes, open wounds, and sores. Tissue loss is a late-stage symptom of peripheral artery disease.

Peripheral Artery Disease Diagnosis

Diagnosis of peripheral artery disease typically starts with a screening of your risk factors, and is followed up with specialized diagnostic techniques to understand the health of the arteries in your legs. Get the full workup at ProVascularMD, and get started on your journey to healthy legs.

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Screening

Peripheral artery disease screening is recommended for everyone that meets certain risk factors, the most common of which include being over the age of 65, history of diabetes, history of smoking, or history of another atherosclerotic cardiovascular condition.

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Ankle-Brachial Index

The ankle-brachial index (ABI) is one of the most common screening methods for peripheral artery disease. ABI is used to assess how well blood is flowing in the legs by measuring blood pressure in the ankles and comparing it to blood pressure in the arms.

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Imaging

In the hands of a trained technician, ultrasound can help pinpoint the location and severity of peripheral artery disease, while advanced vascular imaging techniques such as CTA, MRA, and contrast arteriography can provide rich detail on arterial flow and blockages.

Peripheral Artery Disease Treatment

The goal of peripheral artery disease treatment is to open block vessels and re-establish blood flow throughout the lowe extremity. At ProVascularMD, we have extensive experience in minimally invasive peripheral artery disease treatments including balloon angioplasty, stenting, and atherectomy. We also partner with our colleagues in wound care, podiatry, endocrinology, vascular surgery, and other specialties that are essential to healing the lower extremities. Learn more about the treatments we offer for peripheral artery disease below.

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Balloon Angioplasty

Balloon angioplasty involves threading a wire through the narrowed or blocked artery along the length of the blood vessel. A deflated balloon is placed over the wire and then inflated, opening the blockage and allowing blood to flow more freely through the treated artery.

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Stenting

Stenting involves the placement of a small tubular device that holds the artery open, often immediately after balloon angioplasty is performed. The goal of stenting is to prevent the artery from closing again and to help maintain healthy blood flow.

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Atherectomy

Atherectomy devices cut through or shave away tough plaque in the artery, not unlike a drill or a sanding device. Atherectomy is typically reserved for totally occluded arteries or arteries with hard, calcified plaques that are unsafe to open with balloon angioplasty alone.

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Bypass Surgery

Bypass surgery can be used to re-establish blood flow between a proximal artery (closer to the heart) and one that’s more distal (farther from the heart) by grafting in a vessel. Bypass surgery is often used when minimally invasive revascularization is not possible.

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Endarterectomy

Endarterectomy is the surgical removal of part of the inner lining of the artery along with any plaque deposits that may be obstructing the vessel. Endarterectomy is a common approach to peripheral artery disease when minimally invasive revascularization is not possible.

Be Confident In Your Care Decisions

PAD Education Center

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Peripheral Artery Disease Screening:
Why Early Detection is Critical

Left to its natural progression, peripheral artery disease can lead to seriously impaired ambulation, worsening leg pain, ulceration, gangrene, and even amputation in the most dire cases. The rise in obesity, diabetes, and high blood pressure in America, and the continued prevalence of smoking have set the stage for a quiet pandemic that sees more than 50,000 avoidable amputations every year. Be part of the solution.

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Treatment Options for PAD:
Intro to Arterial Revascularization

In the hands of a dedicated Vascular Specialist, endovascular therapies can effectively restore blood flow to the lower extremities, reverse tissue loss, restore function, and salvage limbs on track for amputation. Here we provide a 101 on the treatment options available for lower extremity arterial disease, with a focus on endovascular techniques and technology for the primary care physician.

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Amputation Prevention

Amputation is a critical juncture in the natural progression of diabetes and vascular disease. It is associated with high mortality rates, high healthcare costs, and an irreversible reduction in quality of life. No matter the circumstance, the decision to amputate should not be made lightly and care providers should seek every viable alternative for their patients.

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Limb Salvage

Many amputations are preventable with modern vascular approaches, so the possibility of limb salvage surgery should always be evaluated before an amputation is prescribed. As vascular specialists, we play a critical role in treating the underlying occlusion and restoring blood flow, but this is one of many components of care that are needed to maximize the patient’s chances of healing.

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